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This Week in Health Care Reform: August 4th, 2017

Lawmakers look to find bipartisan health care reform solutions; uncertainty continues to plague cost-sharing reduction subsidies; a new bill seeks to reduce telehealth restrictions; and, the ongoing effort to reshape our health care system brings together stakeholders.

Week in Review

Bipartisan Next Steps: In the immediate aftermath of last week’s failed attempt in the Senate to pass legislation aimed at repealing the Affordable Care Act (ACA), a renewed spirit of bipartisanship surfaced on Capitol Hill as lawmakers sought to find a compromise that could help break through the legislative stalemate that has hamstrung efforts to fix the health care law.  On Monday, dozens of House members dubbing themselves the “Problem Solvers Caucus” released a set of recommendations drawing on ideas from both sides of the aisle.  Meanwhile, on the Senate side, HELP Committee Chairman, Lamar Alexander (R-Tennessee), released a joint statement with Ranking Member Patty Murray (D-Washington) announcing that the Committee would begin holding bipartisan hearings in September focused on stabilizing and strengthening the ACA’s individual market.  These efforts notwithstanding, challenges remain as dissonance between Congressional Republicans and the Administration threatens to derail this train before it even leaves the station.

CSR Uncertainty: One specific area in which this divide is most evident is on the issue of funding for the ACA’s cost-sharing reduction (CSR) subsidies.  Despite near universal consensus from stakeholder groups on the need for elected officials to address CSR funding as a means of injecting stability into the faltering individual market, agreement on whether or not to make these payments permanent remains elusive.  On Wednesday, a bipartisan group of governors became the latest to add their voice to the growing chorus urging the White House and Congress to fully fund CSRs for the remainder of the year and through 2018.  Separately, a court decision from the day before could help accomplish just that, as the ruling potentially complicates any efforts by lawmakers to abandon the payments without a court fight.

Telehealth Bill: E
ven as Congressional efforts to reform our health care system encounter challenges, market forces continue to shape the manner in which consumers interact with their health care.  In particular, telehealth has distinguished itself in its ability to improve the patient experience in a relatable, practical way.  Seeking to capitalize on those improvements, a new piece of legislation looks to expand telehealth’s reach.  Offered up by Reps. Doris Matsui (D-California) and Bill Johnson (R-Ohio), the bipartisan bill, known as the “Evidence-Based Telehealth Expansion Act of 2017” would ease restrictions on the types of services currently covered by Medicare, exposing more beneficiaries to the benefits of digital health services.

Value-Based Care:
An ancillary benefit of our ongoing health care reform focus has been the recognition that stakeholders need to come together to find workable solutions – all the better if those solutions result, not just in better quality care, but cost savings, too.  Case in point is the growing movement away from traditional fee-for-service to more value-based care.  While momentum continues to show progress in that direction, much work still remains, this, according to a new study commissioned jointly by Quest Diagnostics and Inovalon.  Titled “Progress on the Path to Value-Based Care”, the study consists of results from an online survey of providers and health care executives.  Key takeaways include: A growing percentage of respondents who felt that our system has already achieved value-based status; an increase in sentiment that physicians have the tools they need to be successful in a value-based health care system; and, a decrease in the percentage of physicians who said they lacked needed information about their patients.  However, the survey revealed some areas of disconnect between respondents, particularly when it comes to aligning health plans and providers in the shared value-based care objective.      

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